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Reactivation of hepatitis B virus in a hepatitis B surface antigen-negative patient with rheumatoid arthritis treated with methotrexate
Modern Rheumatology, 09/14/2011
Watanabe K et al. – The authors report the case of a 57–year–old Japanese woman with rheumatoid arthritis (RA) who developed de–novo hepatitis B virus–related hepatitis after methotrexate (MTX) therapy. Entecavir and oral prednisolone following steroid pulse therapy were administered and her liver function recovered.
- MTX is widely used for RA for its efficiency and safety.
- But some cases of HBV reactivation caused by MTX, including de–novo hepatitis, have been reported.
- Considering these conditions, more attention should be paid when using MTX in patients with RA.
- And more studies are needed to determine who needs screening of HBV, monitoring of HBV–DNA, and prophylaxis with chemotherapy or immunosuppressive therapy.
